Sea Savvy -- The other side of paradise

From sea urchins to fire coral, there’s a host of creatures beneath the surface to be on the lookout for

I could see the lobster up under the ledge. He had seen me and backed in enough to be safe, he thought. Lobsters are curious. Sometimes, even though they’re safe in a cave up under a ledge, they slowly venture out toward the mouth to check out something that interests them — like the scratching sound you can make with the tip of your spear in the sand near the entrance. We call it “tickling the lobster out.” It’s what I was trying to do, very intently.

I was free diving and didn’t have much time to fool around before coming up for air. So my total concentration at the moment was directed to those long feelers and legs creeping out of the darkness. I peered ahead, slowly drifting forward. I didn’t see the fire coral, didn’t know it was there until it ever so lightly touched the side of my neck. The pain was instantaneous, the shock almost overwhelming. The lobster was safe and even more curious, I suppose, as I shot up to the surface.

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That evening, as I rested back aboard our Gulfstar 53 motorsailer, Chez Nous, the pain seemed to worsen. But the pain was nothing compared to the fact that I was having more and more trouble breathing. This was back in the “good ol’ days” of the Bahamas, and we were in one of our favorite anchorages, which meant there were no other boats. The only phone that we knew of was in a village about 30 minutes away in the dinghy. It was in a little pink building on the top of a hill and was open from 9 to 5 … sometimes. There were no doctors or drug stores on the corner (there were no corners).

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I’ll never forget the feeling of lying there, getting less and less air, trying to decide with my wife, Mel, whether we should get on the SSB and start trying to raise the Coast Guard in Miami, several hundred miles away. I said, “No,” but I wasn’t at all sure, as breathing became more difficult and I began to feel a little panic. Mel gave me some Benadryl and slowly, during the night, breathing became easier. We’ve learned since that immediately applying vinegar will help neutralize fire coral toxin.

It’s the real “Real World”

Paradise bites. It’s a good place to be, but it needs to be taken realistically. Many of the problems we see come when people think that going out on the water is like taking a Sunday afternoon trek in the park — that big brother is there looking out for us; that if something happens we simply call 911; that there’s always a clinic or rescue squad on the corner. The farther you venture into paradise, the less this is true.

Some of the tales that follow are great examples of my stupidity; all of them are examples of things that can go wrong and what you can do about it. This may sound a bit negative, but that isn’t the intent. The more you know what to expect, the more you’re likely to have fun instead of trouble.

Before moving on, it’s important to say this: Just as you don’t want to repeat my mistakes, you don’t want to assume that any cure or treatment that works on our boat will work for you. What works on our boat may even be harmful to you. You may have allergies, for instance. If you have any questions, ask your doctor. I’m not giving medical advice.

Frequently there are no doctors in paradise. Sometimes you can find one on another boat, but you can’t rely on that. That’s why we tell our family docs what we’re up to, and have them note it conspicuously in our files. We explain to them that if we call we may have no other alternative so that they’ll take our call if we need long-distance help.

When the reef moved

A few years ago we anchored in a familiar spot in the Bahamas and settled down to enjoy the afternoon. We were startled and dismayed a few hours later to see that we’d apparently dragged close to a reef. At least I assumed we’d dragged because the reef hadn’t been there when we anchored. Then I realized that it hadn’t been there at all in the many years we’d been visiting the spot — and a reef takes years to grow. And just as strangely, Chez Nous didn’t seem to be moving against the shoreline.

I got in the dinghy and motored over to this “reef” that hadn’t been there before. It turned out to be thousands of thimbles, undulating in seemingly solid lines across the bottom, ready to ruin anybody who swam through. These are little thimble-like reddish-brown jellyfish that come in the spring and can make you miserable with itching, causing blisters and sometimes more severe allergic reactions. (We’ve found that if we swim into them, it helps to strip in unaffected seawater, just before we climb back aboard, and wash off thoroughly.) They frequently collect around your face mask and in the outer areas of your bathing suit.

Mature thimbles are large enough to notice before you swim into them. When they’re in their larval stage, however, they’re just specs. They look like pinpoint-size reddish dust, sometimes floating in clouds, in tropical waters, even occasionally at the beaches of South Florida. These babies are not nice. We call them “sea lice.” Others use that term to describe other creatures and perhaps properly so, but I don’t care what you call them, they itch. They’re small enough to get under and inside bathing suits, and even wet suits and face masks. They’re almost invisible unless you know what you’re looking for.

I knew what I was looking for in the spring of 2003 while diving in the Berrys, a chain of islands northwest of Nassau. I was looking for conch, and I’d finally found them. I wasn’t looking for sea lice, but I should have been because I’d been virtually incapacitated by them on numerous occasions. As I swam, I finally realized why the water around me was cloudy. Clambering into our tender, the expression on Mel’s face changed to one I’d seen before. “Good grief, he’s done it again.” Within the 20 minutes it took to get back to Chez Nous I had stripped off my wet suit, and the torment had begun. It lasted for about two weeks, over much of my body.

The best cure for sea lice is to stay out of the water when you see them. Some people are less susceptible to sea lice, but don’t assume you’re invulnerable just because you haven’t had problems in the past. I’ve noticed that over the years any immunity I’ve had to things in the sea that sting or itch seems to diminish with the number of encounters.

Some professional salvage divers, who sometimes must go down into clouds of sea lice, rub grease all over their bodies. I’ve known some to even rub on motor oil. Waterproof suntan lotion, liberally applied, also may help. I haven’t used it, but you can buy Safe Sea Jellyfish and Sea Lice Lotion, which the manufacturer says will offer protection (www.safesea.net). It also contains sun block. Be sure to read all warnings on this and all products.

I’ve found that when I’m itching from thimbles or sea lice, frequent rubdowns with rubbing alcohol or vinegar help, as does Benadryl and other over-the-counter antihistamines. But these provide temporary relief — only time heals. These may not be good for you, and something else may work better.

Cute little baby killer conch

Before conch turn into flared-lipped beauties, before they’ve matured into rollers, they’re quite tiny. They sometimes frequent shallow waters of tidal flats, or just off the beaches where people like to wade. As conch grow older, the constant abrasion of the sand and other sediments tends to round off the sharp points of their shells. But the babies are sharp and hard to see because of their size, and because their colors blend in with the bottom.

If you step on one, a sharp point may puncture your skin and break off, leaving a tiny portion of it in your body. That little shell particle is likely to have microscopic sea creatures on it, maybe tiny coral. That nice salty meat (your flesh) can be a great place for them to thrive. The puncture will hurt, and you’ll want to do something about it, as with any wound.

A natural reaction with many shallow wounds is to apply antiseptics containing iodine. We don’t do it with any scrape, scratch, or especially a puncture from conch or anything else in the tropical seas, such as pieces of coral, rock or other shell. We don’t because it’s been our experience, and that of various friends, that any microscopic creatures that may be lingering in that wound seem to thrive on the stuff. I’ve asked doctors about this and been told that since iodine is found in seawater, this makes some sense. Also, we don’t immediately apply ointments like Polysporin or Neosporin, which could make the wound quickly heal over. When we’ve done this in the past, we’ve often found that any particulate left inside had a field day in there, leading to infection.

Instead, we wash the wound with clean fresh water, scrubbing if necessary to be sure anything that got in there is out. (Rum helps, taken orally. Yes, you can tell I’m not giving medical advice.) Then we apply hydrogen peroxide liberally, sometimes for days. This kills bad guys and helps to bubble out tiny foreign particulate. We take along at least a half-dozen bottles of hydrogen peroxide whenever we leave the States for the Bahamas. Only after we’re sure there’s nothing else inside the flesh do we apply medicines that will make the wound start healing over.

The spine’s prick

Sea urchins are cute little round balls of black spines. We’re seeing more and more of them in crevices and holes under water, or even on open bottom. If you touch or step on one, the sting hurts enough to tell you that you’ve really made a mistake. Like little conch, they often leave a part of themselves within.

The tip of a sea urchin spine may be hard to see. It may look like a black spec under your red, painful flesh, and it may be very difficult to remove. Dr. Michael H Beilan’s “Your Offshore Doctor” (Sheridan House) says to soak the area in vinegar several times a day to dissolve that which can’t be pulled out. When you head out into paradise, take one or more good cruising medical reference books with you.

There seems no limit to prickly things at sea. Our youngest daughter, Carolyn, once picked up a pretty shell while wading in some mangrove shallows in the Bahamas. The spines from the bristle worm hiding inside caused her — and us — problems for weeks.

Barbie Ray

Capt. John Smith did a lot of boating in his day, back in the 1600s. He was into fishing, too. One fine sunny day he was wading in the shallows off a spit of land stretching east between the Rappahannock and the Piankatank rivers in Virginia. The waters were so clear and the fish so plentiful that he was spearing them with his sword. He didn’t see what I saw recently near there. It was a ray, camouflaged under the sand, only its eyes protruding, waiting for something interesting to swim by.

When the good captain stepped on the ray, the ray did its thing. Its thing, under those circumstances, was to whip up its tail and plant the barb into the offending party. This was so painful that the captain assumed he was dying, and had his men dig his grave and lay him out on the beach facing Chesapeake Bay. Eventually the pain subsided. (It’s said that the application of local herbs by his American Indian friends helped.)

The grave filled with sand, the spit was named Stingray Point, and Capt. Smith is no longer with us except in spirit. The rays are still with us, though, looking pretty much the same. We see them up and down the East Coast, as well as their much larger brethren, the spotted-eagle ray and the manta. They’re beautiful when we’re diving and see them swimming as if in flight.

Recently a friend fishing with his son in the Chesapeake hooked a sting ray and grabbed its “wings” to try to hold it to remove the hook. The tail quickly lashed up and got him. These stings usually aren’t lethal, but they can be depending upon your state of health and other factors. If it happens to you or someone with you, get to a doctor if possible. When wading always be on the lookout for that telltale hump of sand with the eyes, and never try to handle them.

Know thy fish

It was the mid-1980s, and we were in a safe harbor in the central Bahamas. There was a village ashore, and we did something we’ll never do again: We ate in a restaurant. It’s not that we haven’t eaten in a restaurant since; it’s what we ate. We had the “grouper casserole,” which meant we ate fish when we couldn’t see the whole fish, and we didn’t know for sure what it was.

That evening Mel started having some very weird problems. Hot felt cold, and cold felt hot. She had a tingling in her lips and fingers, her stomach was upset, and she was weak in the knees and joints. Around 2 a.m. our oldest daughter, Melanie, then 6 years old, awoke and started crying, complaining of pain in her knees. We were cruising with some good medical books, but none covered the symptoms. But we knew from recent magazine articles and friends what it was: ciguatera poisoning.

It was little known by doctors at the time, but it had become well known to us. I’ll never forget that night, standing with the SSB microphone in my hand, once again ready to call for medical help. It probably would have been a medevac helicopter, and cost around $10,000. I didn’t make the call because the symptoms seemed to have spiked, at least for the time. Melanie improved in hours, but it took months for Mel to become asymptomatic. During that time she became exceptionally photo sensitive (eyes hurt in bright sunlight), and became unable to tolerate alcohol and caffeine. (Other symptoms may include dizziness, numbness and tingling, blurred vision, localized muscle weakness, nausea, and even a slowing of the heart and low blood pressure.)

Ciguatera poisoning, sometimes known as “fish poisoning,” is caused by a toxin produced by single-celled dinoflagellates that grow on coral reefs. The dinoflagellates are eaten by small fish, which are eaten by larger fish. The toxin buildup is cumulative, so its presence may be greater as you move up the food chain. The toxin is colorless, odorless and isn’t destroyed by cooking, freezing or drying. It seems to be harmless to the fish. When humans eat a fish that contains enough of the toxin, they become sick. You may already have the toxin in your body, though not enough to trigger observable reactions. But then you eat a fish that contains just enough to put you over your limit of tolerance.

The symptoms can last from hours to years. The toxin remains in the body, and even though symptoms have ceased, you could later eat a fish containing just enough of the toxin to cause problems again. Suspect fish include those that eat reef-feeding fish, or that are up the food chain from them. In other words, we avoid most fish that tend to hunt around reef. These frequently include barracuda, some groupers, hogfish, parrot fish, amberjack, mackerel and red snapper.

The larger the fish, the more likely there is to be a problem because of the cumulative nature of the toxin. We’ve also heard numerous reports of old, thick-lipped conch causing the same symptoms. Usually pelagic fish such as wahoo and dolphin aren’t as likely to cause a problem. Even more worrisome is the fact that only some coral reefs contain the dino-flagellates. Reef on one side of an island may be fine, while reef on the other may present a problem. This is why it’s important to heed local knowledge.

But there’s a lot of “local knowledge” out there as to detection and cure that we don’t heed, including such myths as cats won’t eat affected fish, or flies won’t land on it, or gorging yourself on coconut milk helps. If you think you have ciguatera poisoning, get medical help. When our family got it we discovered that it was very hard to find a doctor who knew anything about it. Knowledge is more widespread now.

Dr. Donna Blythe, a Miami internist, says she specializes in ciguatera cases and maintains what she refers to as a ciguatera hotline for patients and their physicians at (305) 661-0774. Doctors have told us that treatment of ciguatera poisoning frequently deals with controlling the symptoms, such as dehydration and some of the neurological problems. Sometimes it may include intravenous Mannitol. But please get your advice from a knowledgeable doctor, not from me.

Our course of action since that fateful lunch has been to never eat large fish that could be affected, and to never eat any of the suspect species mentioned here. When we go to restaurants (We seldom do — I’m a boating writer), we don’t eat any fish unless we can see the whole fish so that we know it’s what they say it is, rather than a chunk of some huge suspect fish — or unless we feel completely comfortable with what the restaurant is telling us. The problem here is that the restaurant’s supplier may not even know. We love fish and still eat it whenever we can, including in restaurants. We’re just very careful.

You can buy a test called Cigua-Check. The manufacturer, ToxiTec — (808) 531-3017 — claims 92 percent sensitivity in detecting ciguatera toxin. In theory, this means that of 12 fish containing the toxin, it will detect 11. A three-test kit is available for $27.99 from www.cigua.com, where you can read other information about the test and Ciguatera poisoning. The kits have a six-month shelf life, according to the manufacturer.

“Just a little barnacle”

One beautiful August day in the Chesapeake, I was hanging out under water (under my boat), cleaning slime and barnacles from the prop and struts. I usually do this free diving, bobbing up and down for air as needed. This means I try to get as much done as I can each trip down. As I worked with a paint scraper inside the V strut, I scraped a knuckle on a barnacle on the other side. No big deal, do it all the time … or so I thought. When I finished I put a lot of hydrogen peroxide on it for a day or so and forgot about it. But the scrape didn’t really heal. A week or so later I noticed a small lump (looked a little like a wart) on my knuckle, and it seemed to be hurting more. I went to a doctor friend who sees a lot of watermen. “Oh yeah,” he chortled. “That’s Mycobacteria marinum.”

“Huh?” I said.

He filled me in. “It’s a small bacterium, which is pretty rare, but I’m seeing more and more of it with people working out in the Bay.”

He and another doctor friend have told me that this infection usually becomes really evident two to three weeks after exposure to the water. It may begin as a small, violet bump on the hands or lower arms, but it can slowly enlarge to a non-healing sore about a quarter- to a half-inch in diameter. It’s usually treated with antibiotics, but if it’s ignored it can affect joints and tendons and other structures, causing serious permanent problems.

Ever since that day, I’ve done one simple thing that, so far, has prevented such scrapes. I never clean or work on my bottom without wearing heavy-duty cloth-lined rubber gloves. They’re cheap; they don’t get in the way; and they really help. I also wear a wet suit with long sleeves, even in the summertime.

The flesh-eating bug

A friend was sitting on a dock on a tributary of the Chesapeake when a skier came by and splashed a little water on him. He’s a good guy, and laughed it off. But not for long. Apparently that little splash contained a tiny organism called Vibrio vulnificus. It grows in brackish or salt water, and can cause all sorts of trouble — perhaps the least of which is gastrointestinal problems, especially if you eat contaminated oysters. But there’s another infection from Vibrio that may be less common but can be much more severe. It affects the skin and soft tissues.

These infections are more likely to occur in people with liver disease or other problems that may lower resistance to infection. The infection can destroy tissue rapidly. Symptoms usually arise 24 to 48 hours after exposure, and begin with tenderness, redness and swelling around the wound. It can go within hours to blistering, ulceration and tissue breakdown. Systemic infection, which is extremely serious, can also occur.

If you have a sore that has been exposed to salt water and it rapidly gets worse, consider that Vibrio is a possibility and don’t fool around. Doctors have told me that there are some common antibiotics that can be effective against this bacterium, including doxycycline and ciprofloxacin. But get yourself to a doctor quickly for an evaluation and treatment of your condition, and make sure that he or she is aware of this as a possible cause of your problem.

Look Ma …

A few examples to remind us who’s really in charge. The young lady sat in her dinghy, anticipating a good seafood dinner after an afternoon of diving in clear tropical waters. After cleaning her catch she splashed it down into the water to remove any blood. There was a sharp tug. She pulled it up. It wasn’t there — nor was her hand. Something, a barracuda or shark, had taken it off. Those who saw the wound said it looked like it had been made by a barracuda.

I have a friend who was diving on a reef and was attacked by a barracuda that tore huge chunks out of his leg. But barracuda don’t hold the spotlight. In the 1970s, Mel and I were fishing with a friend in the Chesapeake, and she hooked a nice bluefish. The blue clamped its jaw around the base of her thumb, and it took a screwdriver, pliers, Mel, the friend, and me to get the fish off.

It was high tide in the mangroves on our special island in the Bahamas, and my very young daughters had just come in from wading in the shallow waters among the roots. Suddenly we heard and then saw a huge splashing and thrashing where the water was no more than a couple of feet deep. We looked intently, and when the water settled briefly we spotted a huge hammerhead shark foraging for food in the wading waters. At least 2/3 of its massive body was out of the water, it was that shallow.

The shark seemed to have no diminution of strength, even though it was dragging bottom and was mostly out of the water. Later, some Bahamian friends told us of a dead pig that had been in the waters of another harbor. The pig had floated up on the beach during a spring tide. At low tide, it was well above the ocean’s edge, but a little of its blood was running down the sand. They watched in amazement as a hammerhead swam to the beach, wriggled its way up to the pig, and dragged it back into the sea.

The point with all this is not that these are “evil” creatures or that we shouldn’t passionately enjoy the sea. The point is that it drives me nuts to hear some know-it-all say something like, “Oh, barracuda never hurt you.” Or, “I swim with sharks all the time. It’s OK.”

When we’re in the sea we’re in a different world, with creatures that do things to which we’re not accustomed. For example, they like to eat and are programmed to become excited by all sorts of things, some of which we may understand (like blood in the water) and some of which we may not. In more than 50 years of boating, I’ve known of many people getting hurt or coming close to getting hurt by taking chances, assuming a cavalier attitude, not being respectful of what the sea can do, forgetting that it isn’t our world. It’s theirs — the shark, the barracuda, and many other creatures — and when we’re in the water, they’ve got the upper hand.